Acute renal failure following lung transplantation: risk factors, mortality, and long-term consequences

Jacques, Frédéric; El-Hamamsy, Ismaı̈l; Fortier, Annik; Maltais, Simon; Perrault, Louis P.; Liberman, Moïshe; Noiseux, Nicolas; Ferraro, Pasquale

doi:10.1016/j.ejcts.2011.04.034

Cited by 31 publications

(46 citation statements)

References 21 publications

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“…The prevalence of AKI and RRT in our data were higher than in previous reports (41.2% and 16.2%, respectively), the finding in our study that the need for RRT after lung transplantation increased mortality was similar to previous reports (29,30). Several studies have shown the reasons for the high risk of AKI in recipients of lung transplantation; for example, lung injury could induce inflammatory mediators of the renal epithelium, nephrotoxic agents including calcineurin inhibitors could induce direct injury, and efforts to maintain negative balance might cause kidney injury after transplantation.…”

Section: Discussioncontrasting

confidence: 57%

“…AKI after lung transplantation developed in 37%, and the incidence of RRT was 5.51% in some previous studies (29,30). The prevalence of AKI and RRT in our data were higher than in previous reports (41.2% and 16.2%, respectively), the finding in our study that the need for RRT after lung transplantation increased mortality was similar to previous reports (29,30).…”

Section: Discussioncontrasting

confidence: 54%

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Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea

et al. 2017

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Background: Most studies about the risk factors of 1-year mortality after lung transplantation were performed on non-Asians. This study aimed to evaluate the perioperative factors related to the 1-year mortality after lung transplantation in Korea.Methods: Sixty-eight consecutive patients who underwent lung transplantation without preoperative extracorporeal membrane oxygenation treatment at 1 tertiary hospital in South Korea between October 24, 2012, and October 16, 2015, were analyzed retrospectively.Results: Forty-four patients (64.7%) lived for >1 year after lung transplantation. The median age of all patients was 55 years (range, 16-75 years), and men accounted for 57.4%. The major cause of lung transplantation was idiopathic pulmonary fibrosis (48.5%); the other causes were interstitial lung disease related to connective tissue disease (17.6%) and bronchiolitis obliterans after stem cell transplantation (14.7%). In univariate analysis, higher median age (52 vs. 61.5 years, P<0.001), male sex (45.5% vs. 79.2%, P=0.007), lower preoperative albumin level (<3 g/dL) (22.7% vs. 45.8%, P=0.049), need for renal replacement therapy (RRT) after surgery (4.5% vs. 37.5%, P=0.001), and postoperative delta neutrophil index (DNI) >5.5 higher than the preoperative DNI (22.7% vs. 70.8%, P<0.001) were significantly related to 1-year mortality.After adjustments, old age, postoperative increased DNI, and need for RRT after transplantation were the independent perioperative risk factors for 1-year mortality after lung transplantation. Conclusions:Recipients with advanced age should be carefully selected, and patients who need RRT or with increased DNI after transplantation should be managed accordingly. J Thorac Dis 2017;9(10):4006-4016 jtd.amegroups.com median survival of recipients who survived for >1 year after transplantation is 7.9 years with good prognosis (3). Because the prognosis of recipients who survived for 1 year is very good, some researchers have reported the risk factors for predicting 1-year mortality after lung transplantation (4,5). Although the results were controversial, old age, application of preoperative extracorporeal membrane oxygenation (ECMO), decreased kidney function before the operation and preoperative diabetes mellitus were reported to affect the prognosis of 1-year morality (4-6). Furthermore, recent study showed that the age of lung transplant recipients is increasing recently and the 3-year survival rate is lower in advanced recipients, especially age 65 or older than in younger age group (7).The first lung transplantation in Korea was performed in July 1996, and a total of 284 lung transplantations, including heart-lung transplantations, have been performed until October 2015 (8-10). Although only 1 or 2 procedures were conducted each year until 2003, currently >50 procedures are being performed each year (9). However, the lack of donated lungs and the low utilization rate of donor lungs from declared brain-dead patients are major problems associated with lung transplantation in Korea compa...

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Section: Discussioncontrasting

confidence: 57%

Section: Discussioncontrasting

confidence: 54%

Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea

et al. 2017

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“…In contrast, previous studies reported that age and female sex had a significant effect on better long-term survival. 8,11 Another previous study showed that outcomes in patients who had interstitial lung disease were comparable or better with single than bilateral lung transplant, and short-and long-term survival were not significantly different for the 2 types of procedures. 15 The findings based on United Network for Organ Sharing data showed that bilateral lung transplant had significantly better survival than single lung transplant.…”

Section: Discussionmentioning

confidence: 99%

“…3 The present study did not confirm a significant effect of type of transplant on survival that was previously reported. 8 In 38 patients who had bilateral lung transplant, 19 patients (50%) died soon after surgery because of technical issues, possibly because of more frequent technical complications after bilateral than single lung transplant.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have evaluated recipient and donor characteristics and have shown that survival is associated with some recipient factors after lung transplant such as age and sex at transplant, body mass index (BMI), nutritional status, type of transplant, and underlying lung disease. [7][8][9][10][11][12] However, some studies investigated sex and age donors, they did not find a significant association with survival. 10,13 However, a literature search showed no previous studies about the effect of different factors on lung transplant mortality in Iran.…”

Section: Introductionmentioning

confidence: 99%

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Hosseini-Baharanchi

Hajizadeh²,

Najafizadeh³

et al. 2014

Exp Clin Transplant

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Results: There were 54 male recipients (78%), and the most frequent indications for transplant included pulmonary fibrosis in 31 patients (45%) and bronchiectasis in 23 patients (33%). Recipient mean age was 36 ± 13 years and body mass index was 20 ± 4 kg/m 2 . Mean half-life (all recipients) was 2 ± 1 years and survival was 73% at 1 month, 67% at 1 year, and 40% at 5 years after transplant. For recipients who survived > 2 weeks after transplant half-life and survival were similar to previously international reported results. Recipient age, sex, type of transplant, body mass index, and pulmonary artery pressure were not associated with survival. Survival was significantly higher with recipient bronchiectasis, younger donors, and female donors. Conclusions: Survival after lung transplant was better with recipients who had bronchiectasis and donors that were younger or female. Patient selection, invasive monitoring, and supportive techniques such as extracorporeal membrane oxygenation for unstable patients during surgery may be helpful.

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A Model‐Based Approach to Assess Unstable Creatinine Clearance in Critically Ill Patients

Ullah

Zöller

Jaehde

et al. 2021

Clin Pharma and Therapeutics

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Creatinine clearance is an important tool to describe the renal elimination of drugs in pharmacokinetic (PK) evaluations and clinical practice. In critically ill patients, unstable kidney function invalidates the steady-state assumption underlying equations, such as Cockcroft-Gault. Although measured creatinine clearance (mCrCL) is often used in nonsteady-state situations, it assumes that observed data are error-free, neglecting frequently occurring errors in urine collection. In contrast, compartmental nonlinear mixed effects models of creatinine allow to describe dynamic changes in kidney function while explicitly accounting for a residual error associated with observations. Based on 530 serum and 373 urine creatinine observations from 138 critically ill patients, a onecompartment creatinine model with zero-order creatinine generation rate (CGR) and first-order CrCL was evaluated. An autoregressive approach for interoccasion variability provided a distinct model improvement compared to a classical approach (Δ Akaike information criterion (AIC) −49.0). Fat-free mass, plasma urea concentration, age, and liver transplantation were significantly related to CrCL, whereas weight and sex were linked to CGR. The modelbased CrCL estimates were superior to standard approaches to estimate CrCL (or glomerular filtration rate) including Cockcroft-Gault, mCrCL, four-variable modification of diet in renal disease (MDRD), six-variable MDRD, and chronic kidney disease epidemiology collaboration as a covariate to describe cefepime and meropenem PKs in terms of objective function value. In conclusion, a dynamic model of creatinine kinetics provides the means to estimate actual CrCL despite dynamic changes in kidney function, and it can easily be incorporated into population PK evaluations.

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Acute renal failure following lung transplantation: risk factors, mortality, and long-term consequences

Cited by 31 publications

References 21 publications

Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea

Perioperative factors associated with 1-year mortality after lung transplantation: a single-center experience in Korea

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A Model‐Based Approach to Assess Unstable Creatinine Clearance in Critically Ill Patients

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